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Case Report

Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature

by
Milena Zamurovic
1,2,
Ana Tomic
2,3,
Katarina Djordjevic
2,
Sara Simanic
2,
Jelena Sopta
2,4,
Lukas Rasulic
2,5,
Ljubica Simic
2,4,
Jovan Jevtic
2,4,
Olga Nedeljkovic-Arsenovic
2,3 and
Marija Rovcanin
1,2,*
1
Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
2
Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
3
University Clinical Center of Serbia, Center for Radiology and Magnetic Resonance Imaging, 11000 Belgrade, Serbia
4
Department for Pathology, Faculty of Medicine, University of Belgrade, Dr Subotica 4/2, 11000 Belgrade, Serbia
5
Department of Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Clinic for Neurosurgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Dr Koste Todorovica 4, 11000 Belgrade, Serbia
*
Author to whom correspondence should be addressed.
Medicina 2023, 59(12), 2161; https://doi.org/10.3390/medicina59122161
Submission received: 17 October 2023 / Revised: 9 December 2023 / Accepted: 11 December 2023 / Published: 13 December 2023
(This article belongs to the Special Issue Diagnosis and Treatment of Endometriosis: Priorities, Advances and Challenges)
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Abstract

Isolated deep infiltrating endometriosis (DIE) of sacral nerve roots or major pelvic nerves, including the sciatic nerve, is considered to be extremely rare. Due to the overlap with sciatica symptoms, the diagnosis of sciatica DIE is difficult yet crucial, as it results in permanent neural damage if left untreated. We report a case of a 45-year-old woman who experienced a three-year-long and recently exacerbating pain in her right leg, accompanied by a tingling sensation and weakness in her right leg and foot, with difficulty walking. In between regular menstrual bleedings, when her aforementioned symptoms worsened, she had been experiencing mild 10-day extra-cyclical bleeding. Her neurologist’s, orthopedist’s, and gynecological examinations were unremarkable. Magnetic resonance imaging (MRI) showed an infiltrative lesion on the right sciatic nerve that was immunohistochemically confirmed to be endometriosis. The patient was treated with gonadotropin-releasing hormone analogues (GnRHa), which led to a significantly diminished size of the lesion on the control MRI, and endometriosis remission was obtained. For persistent mild, but cyclical, pain and muscle weakness, continuous progestagnes were administered, with advice for physical therapy provided for her neuro-muscle rehabilitation and a scheduled check-up in 6 months.
Keywords: female healthcare; endometriosis; sciatic nerve; diagnosis; pharmacotherapy; outcome female healthcare; endometriosis; sciatic nerve; diagnosis; pharmacotherapy; outcome

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MDPI and ACS Style

Zamurovic, M.; Tomic, A.; Djordjevic, K.; Simanic, S.; Sopta, J.; Rasulic, L.; Simic, L.; Jevtic, J.; Nedeljkovic-Arsenovic, O.; Rovcanin, M. Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature. Medicina 2023, 59, 2161. https://doi.org/10.3390/medicina59122161

AMA Style

Zamurovic M, Tomic A, Djordjevic K, Simanic S, Sopta J, Rasulic L, Simic L, Jevtic J, Nedeljkovic-Arsenovic O, Rovcanin M. Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature. Medicina. 2023; 59(12):2161. https://doi.org/10.3390/medicina59122161

Chicago/Turabian Style

Zamurovic, Milena, Ana Tomic, Katarina Djordjevic, Sara Simanic, Jelena Sopta, Lukas Rasulic, Ljubica Simic, Jovan Jevtic, Olga Nedeljkovic-Arsenovic, and Marija Rovcanin. 2023. "Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature" Medicina 59, no. 12: 2161. https://doi.org/10.3390/medicina59122161

APA Style

Zamurovic, M., Tomic, A., Djordjevic, K., Simanic, S., Sopta, J., Rasulic, L., Simic, L., Jevtic, J., Nedeljkovic-Arsenovic, O., & Rovcanin, M. (2023). Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature. Medicina, 59(12), 2161. https://doi.org/10.3390/medicina59122161

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